| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
163 |
161 |
$13K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
26 |
26 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
26 |
25 |
$886.86 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
65 |
57 |
$755.30 |
| 90686 |
|
32 |
28 |
$435.58 |
| 36415 |
Collection of venous blood by venipuncture |
63 |
58 |
$174.00 |
| 81003 |
|
39 |
37 |
$67.50 |
| 87210 |
|
13 |
12 |
$58.20 |
| 0502F |
|
178 |
134 |
$0.33 |
| 0500F |
|
12 |
12 |
$0.03 |